Editorial: We don't know what is killing us

A Scripps Howard News Service study of 4.9 million cause-of-death records for 2005 and 2006 from the Centers for Disease Control and Prevention revealed a disturbing conclusion: Medical experts think about 30 percent of the death diagnoses were either incorrect, fraudulent or just somebody’s wild guess.

That means our knowledge of what’s killing Americans — and more than 2.4 million of us die each year — is not terribly accurate, which greatly complicates the cause of prevention. In particular, heart disease tends to be a catchall cause of death, blamed for 32 percent of deaths in New York state but only 20 percent in Colorado, the state that not coincidentally has the highest rate of autopsies.

Among the findings by reporters Thomas Hargrove and Lee Bowman: Cancer is blamed for 28 percent in the national-capital suburb of Fairfax County, Va., but only 19 percent in Salt Lake City.

In smaller communities, cancer deaths range from more than 40 percent to less than 7 percent, and stroke deaths from nearly 17 percent to less than 1 percent. The wild fluctuations suggest that there is more at work than just regional variations in mortality.

“The result is that we’re spending too much money in the wrong places and not enough on diseases that kill more than the numbers show,” said Dr. Elizabeth Burton of Baylor Medical Center in Dallas.

And the suspect statistics make it difficult to identify new disease patterns, a problem that could become acute with the aging of the boomer generation.

The only 100 percent accurate way to determine the cause of death is to conduct an autopsy, but autopsies are becoming increasingly rare because of the cost, liability worries and even a declining pool of trained pathologists.

There are wide disparities of race, sex and income in the decision to conduct an autopsy, and only 10 states conduct autopsies at least 10 percent of the time. Less than 5 percent of hospital deaths are autopsied.

There is more to an autopsy than just a cause of death. Baylor’s Dr. Burton puts the proposition this way: “When you get a 113-year-old woman into the pathology lab, the question shouldn’t be so much why did she die, but how did she manage to live so long. What was different about her?”

Knowing the cause of death is also about unraveling the mystery of life.